Experts from a variety of research fields discussed concepts in age-related brain and cognitive change and examined future avenues for research at the Cognitive Aging Summit convened recently by NIA.

Nearly 250 investigators gathered to define what characterizes healthy cognitive aging—the ability to think, learn and remember—and to share cross-disciplinary research. Topics ranged from the molecular and cellular mechanisms in cognitive aging, genetic and epigenetic factors, how the plasticity of the brain enables it to adapt with age and possible interventions to promote healthy cognitive aging.

“As the population of Americans over the age of 65 grows, there is tremendous interest in maintaining a healthy brain into advanced age and preventing or slowing cognitive decline,” said Dr. Judith Salerno, NIA deputy director. “This meeting provided a unique opportunity to heighten awareness of current research and bring about greater collaboration in identifying areas for basic studies as well as interventions and therapeutics.”

While there is no set scientific standard for brain health, cognition or ways to measure them, researchers agreed the mental declines typically seen in the elderly are not necessarily inevitable and may be influenced by a variety of factors such as lifestyle choices and environmental influences. Why, researchers asked, do some older people maintain cognitive health while others suffer from significant decline, mild cognitive impairment or dementias such as Alzheimer’s disease?

An area of particular interest was how some older people seem to maintain cognitive function despite clear evidence of pathology in the brain upon examination at death. Researchers have found that some older people displaying little to no cognitive decline are found at autopsy to have significant amounts of amyloid plaque in their brains, a hallmark of Alzheimer’s disease. Discussion centered on the role played by “cognitive reserve” in maintaining synaptic function and the use of different neural networks as we age.

Age does not bring a dramatic loss in the number of neurons in brain regions important to cognitive performance, but rather, appears to be associated with a drop in the function of those cells, according to reports. A healthy aging brain appears to either avoid or compensate for this deterioration; researchers are conducting animal and human studies to explore interventions that may enhance that ability, including hormones, exercise, antioxidants and calorie-restricted diets. Others are looking at the role that education, occupational complexity, wealth and social engagement play in cognitive aging.

Participants expressed optimism about the future of cognitive aging research. Web-based data sets now allow researchers to share extensive collections of genetic and clinical data and advances in brain imaging help identify and measure changes in the healthy aging brain. They agreed, however, that more work must be done in standardizing cognitive testing tools and even defining what constitutes healthy brain aging.

“The challenge is to leave here and not lose this momentum, that this summit becomes the catalyst for answering critical questions about healthy cognitive aging,” said Dr. J. Lee Dockery of the McKnight Brain Research Foundation, whose grant—via FNIH—made the conference possible.

Along with the summit, ongoing NIH activities in this area include the Neuroscience Blueprint, which is developing a toolbox of measures to assess cognition, emotion, sensation and motor functions. Additionally, the Cognitive and Emotional Health Project, including NIA, NIMH and NINDS, was established to coordinate and accelerate research leading to interventions for neurological health.—Peggy Vaughn